Community Oral Health Tips During the COVID-19 Pandemic
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Maintaining a clean mouth is as essential as clean hands.
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Community Oral Health Tips During the COVID-19 Pandemic
- 1. Community Oral Health: Messages During The Covid-19 Pandemic University of Southern California - Community Oral Health J Sumi, RDH, MS 1
- 2. Community oral health messages during the Covid-19 pandemic are important to help the public understand possible emerging relationships of oral health and the coronavirus 2
- 3. Essential Emergency Elective Oral Health During The Pandemic • Essential part of health not recognized • Emergency treatment only was allowed • Elective procedures halted yet mitigated larger problems https://www.clipartkey.com/ 3
- 4. https://commons.wikimedia.org/wiki/File:%22Dental_care_keeps_him_on_the_job%22_-_NARA_-_514788.jpg ORAL HEALTH KEEPS HIM ON THE JOB 4
- 5. • 65% of adults who visited a dentist lost time from work or school from unplanned emergency dental care1 67.5% • 45% of the Nation's working parents missed some work due to their kid's oral health issues2 45% 1. Kelekar U, Naavaal S. Hours Lost to Planned and Unplanned Dental Visits Among US Adults. Prev Chronic Dis 2018;15:170225. 2. 2017 Delta Dental Children's Oral Health Survey Pre-Pandemic Data: Unplanned Dental Visits 5
- 6. PANDEMIC: DELAYEDORALHEALTHCARE 3. Dentists say patients are suffering because routine care can't resume due to coronavirus, COVID-19 pandemic. (2020, May 12) Closures caused delay of treatment potentially transitioning minor cases into more urgent situations3 6
- 7. Oral Self-care Daily Home Care: Clean Hands….Clean Mouth! 7
- 8. Coronavirus Transmission Current evidence suggests the novel coronavirus can be transmitted • Directly through airborne transmission of droplets and aerosols from the mouth4 • Indirectly through contaminated surfaces and may remain viable for hours to days on surfaces made from a variety of materials5 4. Kai-Wang To, Kelvin. et al. Consistent Detection of 2019 Novel Coronavirus in Saliva, Clinical Infectious Diseases, Volume 71, Issue 15, 1 August 2020, Pages 841–843 5. Cai, J., Sun, W., Huang, J., Gamber, M., Wu, J., & He, G. (2020). Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020. Emerging Infectious Diseases, 26(6), 1343-1345. 8
- 9. Mouth • Most common entrance and outlet of droplets and aerosols containing viruses even when just speaking • Saliva contains discharges from nasopharynx and lungs where the coronavirus is known to be present6 • A clean mouth may help to efforts to prevent spread of disease http://www.medicalgraphics.de/en/free- pictures/organs/open-mouth-with-tongue.html 6. Bains, Vivek Kumar, and Rhythm Bains. "Is oral hygiene as important as hand hygiene during COVID-19 pandemic?." Asian Journal of Oral Health and Allied Sciences 10 (2020).9
- 10. “Two Times For Two Minutes” 6. Bains, Vivek Kumar, and Rhythm Bains. "Is oral hygiene as important as hand hygiene during COVID-19 pandemic?." Asian Journal of Oral Health and Allied Sciences 10 (2020). • SARS-CoV-2 virus appears to colonize in the mouth so • Brush and Floss • Antiseptic mouth rinse daily • Sodium lauryl sulfate in toothpaste can be irritating to some however has been shown to reduce the coronavirus6 2 Times 2 Minutes 10
- 11. Overdue? Keep A Healthy Mouth Daily oral care is important! Fluoridated toothpaste and water prevents decay Decrease or eliminate alcohol, tobacco and drug use Watch changes in diet/snacking due to stressful times Don’t neglect oral problem symptoms Continue care when possible: Teledentistry consultations available 11
- 12. Toothbrush Care 7. https://www.newmouth.com/blog/oral-hygiene-covid19/ Clean & Disinfect • Toothbrushes harbor bacteria, viruses, blood, saliva • Rinse in 0.5% H2O2 7 minutes to disinfect5 Replace • Change the toothbrush every 3-4 months and more often during a viral pandemic 12
- 13. Oral Care and Covid Positive Oral hygiene should not be neglected during Covid condition Store oral health products separately during illness4 Disinfect all oral health tools and products daily Discard toothbrush and toothpaste after recovery6 6. Bains, Vivek Kumar, and Rhythm Bains. "Is oral hygiene as important as hand hygiene during COVID-19 pandemic?." Asian Journal of Oral Health and Allied Sciences 10 (2020). 13
- 14. Safety and Covid Positive • Always clean hands before oral care • Dry in upright position with fresh air • Never share toothbrush use • Powered toothbrushes and Water- Pik/oral irrigators may have the potential to produce more aerosols than manual toothbrushes and should be avoided while Covid postive6 6. Bains, Vivek Kumar, and Rhythm Bains. "Is oral hygiene as important as hand hygiene during COVID-19 pandemic?." Asian Journal of Oral Health and Allied Sciences 10 (2020). https://pixabay.com/vectors/toothbr ush-green-dental-hygiene-311373/ 14
- 15. Hands → Mouth → Hands → Mouth • Hands come in contact with the mouth that can transfer viruses in saliva • People touch their face approximately 23 times in an hour for virus threat through oral (mouth), nasal (nose), or conjunctival (eyes) mucosa7 • Wash hands or use hand sanitizer regularly for 20 seconds • Clean surfaces hands touch regularly 7. Oral Hygiene & Coronavirus. Retrieved from https://www.newmouth.com/blog/oral-hygiene-covid19/ on July 6, 202015
- 16. Covid-19 and Poor Oral Health 8. Sampson, V., Kamona, N. & Sampson, A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?. Br Dent J 228, 971– 975 (2020) •4 essential risk factors for severe COVID-197 • Diabetes, high blood pressure, heart disease, and obesity associated with poor oral health •Periodontal disease increases disease risk association • 25% for heart disease, 20% for high blood pressure and 3 times for diabetes8 •Cause is unclear for 52 percent of the deaths due to COVID-19 that occur in healthy individuals • Study showed 20% had that high oral bacterial levels may have affected the progress of COVID-19 since existing associations with severe respiratory complications7 •Improving oral hygiene may prevent the potential risk of airway superinfections of those infected with COVID-19 16
- 17. Mask Mouth: Bad Breath More than 50% of the general population have halitosis9 Wearing face masks Make us more aware of bad breath Causes moist air to evaporate in the mask that can become foul smelling May increases dryness when breathing through the mouth which that may enhance risk for decay and mouth odors 9. Aylıkcı BU, Colak H. Halitosis: From diagnosis to management. J Nat Sci Biol Med. 2013;4(1):14-23. doi:10.4103/0976-9668.107255 17
- 18. 8. https://www.unitedconcordia.com/docs/MaskMouth.pdf Brush your tongue Use mouthwash Dry mouth from medications can cause bad breath Smoking odors can linger in breath and masks Mask Mouth 18
- 19. Oral health is critical to people’s mental health, physical health and just their wellbeing. Good oral health is important during this Covid-19 pandemic. 19
- 20. Keep Your Smile During The Pandemic! Message From Community Oral Health program 20
- 21. References 1. Kelekar U, Naavaal S. Hours Lost to Planned and Unplanned Dental Visits Among US Adults. Prev Chronic Dis 2018;15:170225. 2. 45% of U.S. Parents report missing work due to children's oral health issues. Delta Dental Children's Oral Health Survey (2017, September 18) Retrieved from https://www.deltadental.com/us/en/about-us/press-center/2017/45--of-u-s--parents-report-missing-work-due-to-children-s-oral-h.html. 3. Dentists say patients are suffering because routine care can't resume due to coronavirus, COVID-19 pandemic. (2020, May 12) Retrieved from https://www.newscentermaine.com/article/news/health/coronavirus/dentists-say-patients-are-suffering-because-routine-care-cant-resume-due-to- coronavirus-covid-19-pandemic/97-ba0f761d-9e36-4d12-a6c9-f380919c2da7 4. Kai-Wang To, Kelvin. et al. Consistent Detection of 2019 Novel Coronavirus in Saliva, Clinical Infectious Diseases, Volume 71, Issue 15, 1 August 2020, Pages 841–843 5. Cai, J., Sun, W., Huang, J., Gamber, M., Wu, J., & He, G. (2020). Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020. Emerging Infectious Diseases, 26(6), 1343-1345. https://dx.doi.org/10.3201/eid2606.200412 Bains, Vivek Kumar, and Rhythm Bains. "Is oral hygiene as important as hand hygiene during COVID-19 pandemic?." Asian Journal of Oral Health and Allied Sciences 10 (2020). 6. 6. Bains, Vivek Kumar, and Rhythm Bains. "Is oral hygiene as important as hand hygiene during COVID-19 pandemic?." Asian Journal of Oral Health and Allied Sciences 10 (2020). 7. Oral Hygiene & Coronavirus. Retrieved from https://www.newmouth.com/blog/oral-hygiene-covid19/ on July 6, 2020 8. Sampson, V., Kamona, N. & Sampson, A. Could there be a link between oral hygiene and the severity of SARS-CoV-2 infections?. Br Dent J 228, 971–975 (2020) 9. Aylıkcı BU, Colak H. Halitosis: From diagnosis to management. J Nat Sci Biol Med. 2013;4(1):14-23. doi:10.4103/0976-9668.107255 10. Mask Mouth during COVID-19. Retrieved from https://www.unitedconcordia.com/dental-insurance/dental-health/conditions/covid19/mask-mouth/ on July 10, 2020. 21
Editor's Notes
- The practices to keep good oral health during this pandemic is not only important but a critical message that must be adopted in every community. Let’s explore why.
- Community oral health messages during the Covid-19 pandemic are important to help the public understand the possible emerging relationships of oral health and the coronavirus. When oral health services were abruptly curtailed, community health messages were supposed to ensure that all patients requiring emergency dental care can access appropriate care if their usual dental practice is not able to provide care owing to pandemic influenza-related illness or absence.
- Oral health became Emergency treatment only and not viewed as an Essential part of health. Elective procedures were halted even though they are important to mitigate problems that potentially evolve into Emergencies. Public health, community health and private health were initially unprepared with coordinated messages to guide oral health practices.
- Before the pandemic, multiple Public and Professional Information had studies that showed regular Dental Care keeps those who are working on the job. Neglected oral health practices can keep even essential workers from working.
- 65.5% of adults who visited a dentist lost time from work or school from unplanned emergency dental care. Many who lacked regular preventive dental care delayed diagnosis of oral health problems that became emergencies such as gum problems, tooth decay, tooth loss and dental abscesses. 45% of the Nation's working parents missed some work due to their kid's oral health issues. Many arose from skipped visits to the dentist’s office that resulted in complications that required emergency dental appointments to fix. Keeping our essential workers mouth healthy is not to be overlooked.
- The Pandemic delayed oral health care for many. The closures caused delay of treatment potentially transitioning minor cases into more urgent situations3 Teeth with cavities that could have been filled are now going to need root canals. Teeth that could have been treated with root canals are now going to require extractions. Mouths with oral cancers may have not been discovered and could not get the treatment Even preventive and therapeutic scalings that they need before beginning their dental and medical treatments have been delayed
- Much emphasis has been on having clean hands however maintaining a clean mouth can be significant during this pandemic too.
- Current evidence suggests the novel Cornonavirus can be transmitted directly through airborne transmission of droplet and aerosols from the mouth. Contaminated surfaces can then indirectly transmit the virus as studies have shown that they may remain viable for hours to days on certain surfaces.
- The mouth is the most common entrance and outlet of droplets and aerosols that contain the virus. It can be spread while sneezing and coughing however evidence has shown it can be transmitted even when just speaking, shouting or singing. Saliva contains discharges from the nasopharynx and the lungs where the coronavirus is now to be present. Keeping a clean mouth may help in efforts to prevent the spread of the disease.
- Practice Good Oral Care At Home With Two Times For Two Minutes Since the SARS-CoV-2 virus appears to colonize in the mouth maintaining good oral hygiene at home is more than just trying to prevent cavities, gum disease, and other conditions. Brushing two times for two minutes, flossing and using an antiseptic mouth rinse daily with 1.5% hydrogen peroxide-based rinses such as Colgate Peroxyl, Oragel and Listerine Whitening Mouthwash. Brush your teeth with fluoridated toothpaste. Many toothpastes contain sodium lauryl sulfate which can be irritating to some however has show to reduce the coronavirus.
- Many of us are overdue for our regular check up during this pandemic. Daily oral care now ever so important! Fluoridated toothpaste and water prevents decay Prevent oral conditions by decreasing or eliminating alcohol, tobacco and drug use Sensible healthy nutrition with less hard and sticky food to help protect teeth as many our our diet and snacking has changed during these stressful times Don’t overlook any oral problem symptoms and seek care when and where possible as many dental services are now available Teledentistry consultations are available from many dental providers.
- Many people do not realize their toothbrush can harbor bacteria, blood, and saliva. Not only does improper toothbrush care result in poor oral hygiene over time, but can also spread contagious diseases, such as COVID-19. Clean & Disinfect Your Toothbrush: The coronavirus can stay on surfaces for up to three days, and this may include toothbrushes. However, you can disinfect your toothbrush daily by rinsing it in 0.5 percent hydrogen peroxide for up to 15 minutes. This solution can kill COVID-19 in about one minute. Make sure you rinse off your toothbrush before brushing. Replace Your Toothbrush or Toothbrush Head Often: Everyone is supposed to replace their electric toothbrush head or disposable toothbrush every 3 to 4 months. During the coronavirus pandemic.
- What if you are Covid Positive? Oral hygiene should not be neglected during the Covid condition. Try to store oral health products separately during illness4 Disinfect all oral health tools and products daily and it is very important to Discard and replace the toothbrush and toothpaste after recovery4
- If Covid positive, clean your hands before oral care. Disinfect with hydrogen peroxide or rinse the toothbrush under hot water for a few minutes. Always dry in an upright position with fresh air. If you are living with others, never share your toothbrush. Also, it has been suggested that powered toothbrushes and Water Piks may have the potential to produce more aerosols than manual toothbrushes and should be avoided while being Covid positive.
- It has been a big message that washing the hands help prevent contracting COVID-19. Avoid touching the face, lips, mouth, eyes, and ears with potentially contaminated hands. Studies show that people touch their face approximately 23 times in an hour and this can pose a for virus threat through mouth, nose, or eyes. When a person’s hands touches their own mouth and have the virus in their saliva, they can potentially transfer it to others. It is this cycle of clean hands and mouth that is important to curb the pandemic.
- Can Poor oral health have an association with Covid-19? Four essential risk factors for severe Covid-19 have been identified: diabetes, high blood pressure, heart disease and obesity. All these have also been associated with poor oral health. If an individual has periodontal disease, the increased risk association for heart disease is 25%, high blood pressure is 20% and 3 times the risk for diabetes. Is the oral health relevant here? Studies are suggesting yes. Evidence exists on poor oral health and associations with severe respiratory complications. 52% of the deaths occurred in health individuals and 20% of those had high oral bacterial levels that may have affected the progress of COVID-19 disease. Is the oral health relevant here? This study is suggesting yes. So improving oral hygiene and oral health may prevent the potential risk of the airway superinfections of those infected with Covid-19
- Wearing a mask helps limit droplets and aerosols from our nose and mouth from transferring to one another. Some have become aware of mouth odors when wearing a face mask. More than 50% of the general population have halitosis or bad breath. Wearing a mask can cause the saliva and moist air to cling and dry onto masks to cause a bad smell. Many people breath through their mouths when wearing a mask which can cause dryness which produces mouth odors and can increase risk for cavities.
- So remember to focus on good oral hygiene at home, to have a healthy mouth and reduce mouth odors. Brush your tongue and rinse with a good mouthwash. If you have gum problems, it can cause an odor so contact a dental professional for guidance. Watch what you eat as that can contribute to a smelly mouth. Medications can cause a dry mouth that can add to bad breath. Keep hydrated and find dry mouth products to use. Great time to quit smoking if you are thinking about that right now as that can give you lingering odors and increase your risk for oral problems. And don’t forget to keep you mask clean and fresh.
- Oral health is critical to people’s mental health, physical health and just their wellbeing. We hope our community knows that Oral health is important during this Covid-19 pandemic.
- So keep your smile during the pandemic. This message is brought to you from the Community Oral Health program at the Herman Ostrow School of Dentistry of USC